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Know Your Treatment Options

Expert advice on how to sidestep pitfalls that often accompany depression.

By Jennifer Soong, Reviewed By Louise Chang, MD

When Orion Lyonesse is getting depressed, she turns into a hermit. She doesn't want to leave the house (not even to pick up the mail), and she cuts off contact with her friends and family.

"The more I'm alone, the deeper the depression gets," Lyonesse, an artist and writer in Lake Stevens, Wash., tells WebMD in an email. "I don't even want to cuddle my cats!"

Avoiding social contact is a common pattern you might notice when falling into depression. Some people skip activities they normally enjoy and isolate themselves from the world. Others turn to alcohol or junk food to mask their pain and unhappiness.

Depression traps vary from person to person, but what they have in common is that they can serve to worsen your mood, perpetuating a vicious cycle. Here are six behavioral pitfalls that often accompany depression -- and how you can steer clear of them as you and your doctor or therapist work on getting back on track.

Trap #1: Social Withdrawal

Social withdrawal is the most common telltale sign of depression.

"When we're clinically depressed, there's a very strong urge to pull away from others and to shut down," says Stephen Ilardi, PhD, author of books including The Depression Cure and associate professor of psychology at the University of Kansas. "It turns out to be the exact opposite of what we need."

"In depression, social isolation typically serves to worsen the illness and how we feel," Ilardi says. "Social withdrawal amplifies the brain's stress response. Social contact helps put the brakes on it."

The Fix: Gradually counteract social withdrawal by reaching out to your friends and family. Make a list of the people in your life you want to reconnect with and start by scheduling an activity.

Trap #2: Rumination

A major component of depression is rumination, which involves dwelling and brooding about themes like loss and failure that cause you to feel worse about yourself.

Rumination is a toxic process that leads to negative self-talk such as, "It's my own fault. Who would ever want me a friend?"

"There's a saying, 'When you're in your own mind, you're in enemy territory,'" says Mark Goulston, MD, psychiatrist and author of Get Out of Your Own Way. "You leave yourself open to those thoughts and the danger is believing them."

Rumination can also cause you to interpret neutral events in a negative fashion. For example, when you're buying groceries, you may notice that the checkout person smiles at the person in front of you but doesn't smile at you, so you perceive it as a slight.

"When people are clinically depressed, they will typically spend a lot of time and energy rehearsing negative thoughts, often for long stretches of time," Ilardi says.

The Fix: Redirect your attention to a more absorbing activity, like a social engagement or reading a book.

Trap #3: Self-Medicating With Alcohol

Turning to alcohol or drugs to escape your woes is a pattern that can accompany depression, and it usually causes your depression to get worse.

Alcohol can sometimes relieve a little anxiety, especially social anxiety, but it has a depressing effect on the central nervous system, Goulston says. Plus, it can screw up your sleep.

"It's like a lot of things that we do to cope with feeling bad," he says. "They often make us feel better momentary, but in the long run, they hurt us."

The Fix: Talk to your doctor or health provider if you notice that your drinking habits are making you feel worse. Alcohol can interfere with antidepressants and anxiety medications.

Trap #4: Skipping Exercise

If you're the type of person who likes to go the gym regularly, dropping a series of workouts could signal that something's amiss in your life. The same goes for passing on activities -- such as swimming, yoga, or ballroom dancing -- that you once enjoyed.

When you're depressed, it's unlikely that you'll keep up with a regular exercise program, even though that may be just what the doctor ordered.

Exercise can be enormously therapeutic and beneficial, Ilardi says. Exercise has a powerful antidepressant effect because it boosts levels of serotonin and dopamine, two brain chemicals that often ebb when you're depressed.

"It's a paradoxical situation," Ilardi says. "Your body is capable of physical activity. The problem is your brain is not capable of initiating and getting you to do it."

The Fix: Ilardi recommends finding someone you can trust to help you initiate exercise -- a personal trainer, coach, or even a loved one. "It has to be someone who gets it, who is not going to nag you, but actually give you that prompting and encouragement and accountability," Ilardi says.

Trap #5: Seeking Sugar Highs

When you're feeling down, you may find yourself craving sweets or junk food high in carbs and sugar.

Sugar does have mild mood-elevating properties, says Ilardi, but it's only temporary. Within two hours, blood glucose levels crash, which has a mood-depressing effect.

The Fix: Avoid sugar highs and the inevitable post-sugar crash. It's always wise to eat healthfully, but now more than ever, your mood can't afford to take the hit.

Trap #6: Negative Thinking

When you're depressed, you're prone to negative thinking and talking yourself out of trying new things.

You might say to yourself, "Well, even if I did A, B, and C, it probably wouldn't make me feel any better and it would be a real hassle, so why bother trying at all?"

"That's a huge trap," says Goulston. "If you race ahead and anticipate a negative result, which then causes you to stop trying at all, that is something that will rapidly accelerate your depression and deepen it."

The Fix: Don't get too attached to grim expectations. "You have more control over doing and not doing, than you have over what the result of actions will be," Goulston says. "But there is a much greater chance that if you do, then those results will be positive."